Provider Demographics
NPI:1164516084
Name:ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE INC
Entity Type:Organization
Organization Name:ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANILA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOXHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-745-0623
Mailing Address - Street 1:7601 4TH AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3207
Mailing Address - Country:US
Mailing Address - Phone:718-745-0623
Mailing Address - Fax:718-745-8091
Practice Address - Street 1:7601 4TH AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3207
Practice Address - Country:US
Practice Address - Phone:718-745-0623
Practice Address - Fax:718-745-8091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty